Many Obese Americans Struggle With Stigma, Discrimination, Poll Finds

THURSDAY, Aug. 23 (HealthDay News) — As if the physical woes that accompany obesity aren’t bad enough, many obese Americans say they face discrimination and stigma because of their weight, a new Harris Interactive/HealthDay poll found.

And the levels of stigma rise along with weight, and affect both people’s working and social lives, the poll found.

Fifty-two percent of people who fell into the “obese” or “morbidly obese” categories believe they have been discriminated against when applying for a job or promotion. About two-fifths said they have been socially shunned, and 36 percent felt they’ve been discriminated against when being seated in theaters or restaurants.

Much of this discrimination may still be socially acceptable: According to the poll, a majority of people (61 percent) do not consider negative remarks about a person’s weight to be offensive.

The findings suggest that “the obesity epidemic is not just a huge health-care issue, it is also a social issue with many people, especially those who are morbidly obese — feeling that they have been stigmatized, treated unfairly, or discriminated against because of their weight,” said Humphrey Taylor, chairman of The Harris Poll.

“This is not surprising when many people do not believe that it is very offensive to make critical remarks about people’s weight or for employers to use weight as a factor when deciding whom to hire,” he said.

The online survey was conducted in July and involved nearly 2,300 U.S. adults. Among other questions, the poll asked participants their height and weight to calculate their body mass index (BMI, a ratio of weight to height). A BMI of 30 to 35 is considered obese, and anything higher than that falls into the morbidly obese category. Seventeen percent of respondents were obese while 13 percent were morbidly obese. Thirty-two percent were normal weight and 29 percent were overweight (a BMI of 25 to 29).

Perhaps not surprisingly, the proportion of people who said they felt stigmatized because of their weight rose with their level of obesity. While 6 percent of people who classified themselves as overweight said they felt stigmatized, that number rose to 20 percent and 34 percent for people who were obese or morbidly obese, respectively.

Stigma affected the working lives of many respondents. Almost one in 10 overweight people said they believe their weight may have cost them a job or promotion, as did 17 percent of the obese and 35 percent of the morbidly obese.

Those perceptions may well be rooted in reality, as businesses move to save health-care dollars or improve their image by factoring obesity into their hiring practices. For example, one hospital in Victoria, Texas, made headlines recently by deciding to not hire employees with a BMI higher than 35, citing reasons of personal appearance.

“Some employers may feel that being overweight is associated with being uneducated, lazy, not as ambitious or not as disciplined,” said Sharon Zarabi, a nutritionist and fitness trainer at Lenox Hill Hospital in New York City. Zarabi, who counsels severely obese people before and after weight loss surgery, said that many of her clients reported having been ridiculed for their size.

While one-quarter of all of the people polled thought that such employment policies were “fair,” only 14 percent of those who are morbidly obese thought so.

Carrying excess weight may take a toll on social lives, too. For example, 22 percent of the morbidly obese said they felt they had been left out of social gatherings because of their weight, and a similar number said they had felt discriminated against while being seated at a theater or restaurant, or on a bus, train or plane.

Many of those polled thought it was still acceptable to make hurtful remarks about a person’s weight. For example, while 61 percent thought it was “very” or “extremely” offensive to make racial slurs, only 39 percent felt the same about weight-related comments — including almost half of those who were themselves morbidly obese.

That finding didn’t surprise one medical expert.

“Although many deny it, as in this study, there is enough scientific evidence that weight bias — which is more prevalent than race, sex, color, religious belief [bias] — is widespread and very resistant to change,” said Dr. Sarita Dhuper, director of pediatric cardiology and executive director of the “Live Light Live Right” Pediatric Obesity Program at Brookdale University Hospital and Medical Center in New York City.

She said many people don’t realize that each person’s vulnerability to obesity differs greatly, and in a society where high-calorie food is so abundant, “everyone is susceptible to developing obesity.”

Dhuper added that “making people pay for being obese is like saying it is their entire fault and they have an ability to reverse it. This is still debatable. Obesity may be preventable but unlikely to be reversible without drastic surgical methods for most people.”

And she said that, over time, stigma based on weight or any other factor can have tragic consequences.

“Dealing with bias in the workplace, health-care settings, school and home can lead to internalization and stress, depression, anger, aggression and even suicidal ideation,” Dhuper said.